PuSHMe tested two systems, one voice and the other text-based, that allowed drivers to signal a need for in-vehicle emergency assistance to a monitored response center. Evaluation occurred in four areas: (1) performance, (2) usability, (3) market analysis and (4) institutional issues. It was concluded that these systems could approach 100% successful operation in a truce market deployment though in a simulated deployment there was a 70.5% success rate of all trials. User response was generally favorable. User response was generally favorable. Market analysis suggested numerous strategies, including that pricing should favor usage fees over purchase cost. Institutional analysis found serious obstacles to collaboration between private and public response centers, but also alternatives to the collaborative model such as a focus on non-emergency services or private response groups “becoming” the public emergency service provider through outsourcing.